Validation of asbestos exposure in mesothelioma cases clustered among residents near an asbestos cement pipe production factory and risk estimation of deaths due to mesothelioma.

我们从72例间皮瘤患者或其家属中获取有间皮瘤的胸膜组织、完整的肺组织或胸部CT片，他们同意我们的访谈研究并给予书面知情同意。所有病例均为居住在久保田石棉水泥管生产厂附近的居民。提供胸膜组织，用免疫染色法重新检查病理诊断，其中包括间皮瘤阳性制造者和肺癌阴性制造者。在31例诊断为间皮瘤的病例中，只有1例（3.0%）通过复查组织证实为其他疾病。三位放射学专家一致认为，所有胶片的发现与间皮瘤病例中常见的观察结果一致。结果显示23.7%的研究对象存在胸膜斑块。成功计数了12例肺组织中石棉小体的数量。其中一半的人显示的数字远低于职业接触石棉的工人，但高于没有接触任何石棉的人。5名受试者肺中石棉纤维浓度可计数。在所有研究对象中都发现了青橄榄石纤维。然而，我们无法得出明确的结论，因为这些受试者很可能是在职业或家庭中暴露的。这些结果表明，误诊率比我们想象的要低得多，工厂附近的居民也有接触石棉的情况。在我们采访的178名患有石棉相关疾病的居民中，有73人在1995年1月1日至2006年底期间死于间皮瘤，他们居住在距离工厂1500米以内的地区。在300米范围内，间皮瘤的smr显著增加，男性为14，女性为41。女性中smr的显著升高延伸至离核电站1500米远的地方。

We obtained pleural tissue having mesothelioma, intact lung tissue or chest CT films from 72 mesothelioma cases or their families, who granted our interview study and gave a written informed consent. All cases were residents who had lived near an asbestos cement pipe production plant, Kubota. Pleural tissues were provided for re-examination for pathological diagnosis using an immunostaining assay, which consisted of both positive makers for mesothelioma and negative ones for lung cancer. Of 31 cases whose diagnosis was mesothelioma, only one case (3.0%) turned out to be a different disease by re-examination of the tissue. Three radiographic specialists agreed that all films fad findings consistent with those commonly observed in mesothelioma cases. They indicated an existence of pleural plaque in 23.7% of the study subjects. The number of asbestos bodies in the lung tissue was successfully counted in 12 subjects. Half of them showed the number which was much lower than that of workers exposed to asbestos occupationally but higher than in persons not exposed to asbestos of any kind. Asbestos fiber concentrations in the lung could be counted in five subjects. Fibers of crocidolite were found in all study subjects. However, we could not obtain definite conclusions because these subjects were likely to be exposed occupationally or domestically.These results suggest that misdiagnosis is much lower than we had imagined and neighborhood exposure to asbestos occurred among residents near the plant. Of 178 residents with asbestos-related diseases with whom we made an interview, 73, who lived in the area within 1, 500 meters from the plant, died from mesothelioma after Jan, 1, 1995 till the end of 2006. SMRs of mesothelioma increased significantly as high as 14 among men and 41 among women within 300 meters. A significant elevation of SMRs in women extended as far as 1, 500 meters way from the plant.